Women have sucked up the pain of birth control devices for decades, but do they have to?

When she was in her late 20s, Katie O'Byrne heard about a newer product that promised to eliminate all pregnancy risk without needing to remember to take a birth control pill each day. 

Back in 2010, she paid $450 for the hormonal intrauterine device, or IUD. The tiny T-shaped device — first developed in the 1960s — is inserted in the uterus to prevent pregnancy by changing the way sperm cells move or preventing eggs from leaving ovaries at all.

O'Byrne's IUD offered long-term birth control with less fuss. "You set it and forget it. … That sounds amazing," said the now 39-year-old emergency nurse from Peace River, Alta., about 500 kilometres northwest of Edmonton.

But she wasn't prepared for the agonizing pain of the insertion procedure that would put her off IUDs for years.

O'Byrne, who says she has a high pain tolerance, was told it would feel like a pap exam, a common gynecological procedure where cells are scraped from the cervix and screened for cervical cancer.

"It started off like a pap, but then it just got progressively worse," she said. "I was very surprised the pain was that intense."

O'Byrne said the procedure left her sweating and struggling to drive home. She said she was forced to pull over multiple times. Years later, after childbirth, she realized the pain of the IUD insertion was similar to labour pains.

O'Byrne's experience was echoed by a group of 15 women who spoke to CBC Radio's White Coat, Black Art about their experiences with IUD insertion.

They are part of a growing chorus of voices — from women of child-bearing age to gynecologists on Tik Tok and social media — demanding better education and pain management for IUD users. 

By 2019. about 159 million people worldwide were using IUDs, according data compiled by the United Nations.

IUDs are sold as a reversible, simple, long-term option to less reliable forms of birth control. The IUD can also lower the risk of some types of gynecological and cervical cancers, including endometrial and ovarian cancer.

The copper or hormone-infused device revolutionized birth control and improved reproductive health outcomes, but for some, the insertion can bring severe pain. According to several Canadian women who spoke to CBC that pain was a surprise. 

Alison Steele, 26, of Prescott, Ont., advises women to expect to take a day off to recover after the procedure. "I just remember searing pain," she said. 

"I was screaming and crying. … In my mind, it lasted like an hour. I'm sure it lasted five minutes, but it was pretty brutal."